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Staff Backend Engineer

United States, New York 180000.00 - 220000.00 USD / Year · Job Posted March 21, 2026
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Job Description

Staff Backend Engineer role for a fast-growing healthtech startup building AI-powered tools to help healthcare organizations streamline operations, improve patient engagement, and optimize clinical workflows. The engineer will join a senior team of 10 engineers and lead backend architecture and implementation for two greenfield Rails 8 + Hotwire applications focused on AI-powered chat and workflow automation.

Job Responsibility

  • Lead backend architecture and development for two new Rails 8 applications from the ground up
  • Design and implement scalable APIs, data models, and business logic to power AI-driven chat and workflow automation features in healthcare
  • Build and optimize backend systems for performance, reliability, security, and compliance (critical in healthcare contexts)
  • Integrate AI/ML services and tools (e.g., prompt engineering pipelines, retrieval systems, or external LLM APIs) into Rails applications
  • Own technical decisions around core infrastructure, background processing (e.g., Sidekiq/ActiveJob), caching, and database design (PostgreSQL or similar)
  • Collaborate with frontend engineers to define clear API contracts and enable polished user experiences without owning UI implementation
  • Work with the senior engineering team to establish best practices, review code, and ship production-ready, maintainable backend systems
  • Operate autonomously in a fully remote, product-driven environment while mentoring on backend topics

Requirements

  • 7+ years of experience building production web applications, with deep expertise in backend systems
  • Strong Ruby on Rails experience (ideally Rails 6+), including ActiveRecord, API design, and background jobs (Sidekiq/ActiveJob preferred)
  • Proven track record owning backend architecture end-to-end: from data modeling and schema design to scalability, performance tuning, and fault-tolerant systems
  • Experience integrating AI-powered features (e.g., LLM APIs, vector search, real-time processing, or workflow orchestration)
  • Comfortable collaborating across disciplines—defining API boundaries for frontend teams and partnering with product/design on requirements
  • Experience in autonomous, senior engineering teams and contributing to technical strategy

What we offer

  • Base salary up to $220,000
  • 100% remote within the US
  • Comprehensive benefits package
  • Opportunity to work on AI-powered healthcare products with real-world impact
  • Collaborative environment with a highly experienced engineering team

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